Treatment Options For Kidney Stones

Waiting and Watching

In about 85 percent of cases, kidney stones are small enough to pass during urination, usually within 72 hours of symptom onset. The best treatment for these stones is to drink plenty of water (as much as two to three quarts per day), stay physically active and wait. Painkillers may be prescribed to help with the pain associated with passing a stone.

For patients who will pass a stone without interventions, urinating through a strainer may be recommended so that the stone can be recovered and analyzed. The mineral composition of the kidney stone will dictate appropriate treatment and future preventive measures.

Stones that are too large to pass on their own or which may cause bleeding, kidney damage or ongoing urinary tract infection may need surgical treatment.

Minimally Invasive Treatments

Extracorporeal shock wave lithotripsy (ESWL)

ESWL is the usual way to remove stones about 1.5 centimeters or smaller. Mayo Clinic was among the first medical centers in the United States to use shock waves for treatment of kidney stones.

The patient is partially submerged in a tub of water during the procedure. The doctor uses X-rays to monitor the location and status of the stone as shock waves continually pound the stone. When generated, each shock wave produces a loud noise, so patients wear earphones to protect their hearing. In many cases the stone will begin to crumble after 200 to 400 shock waves. The sand like particles that remain after treatment are easily passed in the urine.

The shock waves are painful, so the procedure is performed with sedatives, local anesthesia or general anesthesia.

At other centers the patient may lie on a cushion for the treatment. Mayo Clinic urologists use water for all ESWL procedures because the machines used to transmit shock waves through water generate more powerful waves, making it more likely that stones can be eliminated in a single treatment.

Some side effects of ESWL include blood in the urine for a short time after the procedure and minor bruising on the back or abdomen. Some patients may also experience discomfort as the stone fragments pass through the urinary tract, and others may need another treatment if the stone doesn't shatter completely. Most patients resume normal activity in a few days, but it may take months for all the stone fragments to pass.

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